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FISS/DDE Provider Online Guide: Resources


FISS Reason Code Overview

FISS reason codes are five-digit codes that direct the outcome of a claim edit or process; they are the “traffic cops” of the system. The following chart outlines the various positions of the FISS reason code.

If Position 1 = Then Edit Type = And Positions 2–5 Can Be =
1 Consistency edits 0125–999
3 FISS 0000–9799
4 File maintenance Alpha 001–Alpha 899
5 Medical review 0001–999
7 Site specific (non-medical) 0001–999
A–Z CWF (except W) Current CWF four-digit error codes
W IOCE/MCE and Grouper 0001–999

 

FISS/DDE Provider Online Guide: Resources - FISS Reason Code Overview
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